February 2015
HEDIS® medical record reviews begin March 2015
Blue Cross Blue Shield of Michigan conducts Healthcare Effectiveness Data and Information Set medical record reviews annually from March through May. Inovalon™ will perform the HEDIS reviews on behalf of Blue Cross PPO and Medicare Plus BlueSM members who received services in Michigan.
For the HEDIS reviews, Inovalon looks for details that may not have been captured in claims data, such as blood pressure readings, HbA1c lab results, colorectal screenings and body mass index. This information helps us enhance our member quality improvement initiatives.
Inovalon will contact you to schedule an appointment for a HEDIS review or request that you fax the necessary records. HEDIS requires proof of service documentation for data collected from a medical record. Blue Cross will reimburse you $5 for each chart requested and received.
Inovalon will continue to perform the risk adjustment medical record review on behalf of Blue Cross Medicare Plus Blue members who received services in Michigan. These reviews are in addition to the risk adjustment and HEDIS medical record review process performed by Verisk on behalf of the Blue Cross Blue Shield Association. |